Inspection on 23/08/05 for St Paul`s Convent

This inspection was carried out on 23rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Paul`s Convent 11/05/09

St Paul`s Convent 20/06/07

St Paul`s Convent 21/02/06

St Paul`s Convent 19/01/05

St Paul`s Convent 29/07/04

St Paul`s Convent 04/11/03

St Paul`s Convent 14/05/03

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Maple Lodge

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Inspirations

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE St Pauls Convent The Infirmary, 94 Selly Park Road Selly Park Birmingham B29 7LL Lead Inspector Jane Walton Announced 23 August 2005 rd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Pauls Convent Address The Infirmary 94 Selly Park Road Selly Park Birmingham B29 7LL 0121 415 6100 0121 414 1063 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Sisters of Charity of St Paul Sister Eileen OGorman Care Home 36 Category(ies) of Care Home registration, with number of places St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 36 Sisters of the Order only may be cared for in the home. 2. 35 places for the provision of nursing care. 3. 1 place for the provision of nursing care. 4. That the manager successfully completes the Registered Managers Award (NVQ Level 4 in Care Management) or equivalent by April 2005.. Date of last inspection 19th January 2005 Brief Description of the Service: St Paul’s infirmary is located within the Convent of St Paul’s in a pleasant residential area of South Birmingham. The infirmary consists of a four-storey building attached to the main convent and only caters for Sisters of St Paul’s who have nursing needs. Access to the upper floors is via stairs or passenger lifts. The building is very spacious and all residents have a single room. The home provides twenty-four hour nursing care ranging from long term nursing needs to short stay rehabilitation. The Convent has its own pleasant extensive gardens and grounds, which are very well maintained and easily accessed by residents. There is a house within the grounds for family members of Sisters of the Order to stay in when visiting their relatives. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced inspection was undertaken by one inspector over one day, and was assisted throughout the process by the Registered Manager. There were 32 residents in the home at the time, with a further three in hospital. The inspector spoke with thirteen residents. Information was also gathered by observing staff performing their duties, formal discussions with two, and informal discussions with eight members of the staff. Ongoing discussions throughout the inspection process took place with the manager. The inspector also met with the responsible individual for the home, for the feedback session at the conclusion of the inspection. Care records were examined and a medication audit carried out. This report has been delayed due to the inspectors extended sick leave. Subsequently, any requirements made of the home that were not immediate at the time of the inspection, have necessarily been given extended time scales. This report should be read in conjunction with the latest inspection report in order to obtain a complete overview of the service offered by this home. What the service does well: All Sisters who are resident in the Infirmary are provided with the information that they require to make an informed choice about living in the home. A full assessment is carried out, and regularly reviewed to ensure that all identified needs are being met. Each Sister has a comprehensive care plan that they have been involved in producing where possible. Health care needs are met and Sisters are visited by GP’s and other health professionals as required. When a Sister requires palliative care, support is provided by the Macmillan nurses from St. Mary’s Hospice. The medicine management in the home is of a generally high standard. A range of activities is provided for the Sister to participate in, and they are assisted to participate in the religious services and celebrations of the convent. A well balanced and nutritious diet is provided, which is to the Sisters’ tastes. The dining facilities are of a high standard, and staff have a good understanding of individual likes and dislikes. Policies and procedures in the home ensure that the rights, health and welfare of the Sisters are protected at all times. The ethos and management of the home benefits the Sisters, and their views are actively sought and acted upon. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 6 St. Paul’s Infirmary provides a comfortable, clean and well maintained environment for the Sisters to live in, and there is a high standard of housekeeping in the home. Bedrooms contain personal possessions are comfortably furnished. There is a high ratio of staff to residents that ensures that the high standard of care that the Sisters receive is maintained. Over 90 of the care staff are trained to NVQ level 2 or higher, and as well as the statutory training, staff undertake training in topics such as Tissue Viability, Palliative Care and Dementia. A large ancillary staff is employed at the home, and all contribute to the high standard of care and environment that is provided for the Sisters. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4, & 5 Residents are given clear information about the service provided by St Pauls Convent Infirmary. All the practices and procedures surrounding the admission of new residents were adequate and appropriate to ensure that the home is able to fully meet their needs. EVIDENCE: The home has a Statement of Purpose and a comprehensive Service Uses Guide that were seen to have been updated recently. The home only admits Sisters of the Order who require care, and no Sister is denied admission provided a bed is available. Upon the new residents arrival a full assessment is carried out to identify needs and determine if any specialist equipment is required. Comprehensive assessments were evidenced in care plans and were seen to have been regularly updated. Many of the Sisters who move to the infirmary are already familiar with it as it is an integral part of the convent as a whole. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,&11 Residents are well supported by the care staff to ensure that their health and personal care needs are met appropriately. The medication is very well managed promoting good health. Residents are treated with respect and their privacy is upheld. EVIDENCE: A sample of care plans were examined and found to be comprehensive and easy to understand. Residents needs had been identified and in most cases the care management of these needs was documented clearly. A range of risk assessments had been undertaken, including moving and handling, pressure sore risk and nutritional status. In one instance a resident noted as having celiac disease did not have a care plan in place for the management of this. It was evidenced that the care plans had been prepared with input from the residents themselves. This was confirmed when talking to residents, many of whom said that they were aware they had a care plan and had been consulted in its preparation. The staff refer to the residents GPs and other healthcare professionals as required for medical advice and to ensure that health care needs are being met. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 10 The Macmillan nurses from St Marys Hospice provide regular input when required. Evidence was seen that a chiropodist and an optician visit the home when required. Staff were observed to be interacting appropriately and respectfully with the residents. One resident said,” all the staff are very kind and very polite. I have my own lovely room and they always knock before they enter.” Discussions with staff demonstrated their respect and regard for the Sisters well-being. An audit of the medication administration in the home demonstrated that a generally high standard is maintained. A Measured Dosage System (MDS) is not used, and all medicines are boxed and individually labelled. In two instances the counts of a medication were found to be inaccurate, however all further counts were accurate. There was a medication policy and procedure available, and where one resident was seen to be self medicating, regular checks of compliance and accuracy were evidenced. Controlled drugs were seen to be stored appropriately and all counts were correct. Regular audits of staff administering medications are carried out in order to maintain the high standard evidenced. The wishes of the Sisters and the rights related to death and dying are documented in the care plan. The homes Statement of Purpose states,” at no time is a dying sister left on her own,” however if a Sister expressed a wish to be alone that would be respected. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14,& 15 The dietary needs of residents are well catered for with a balanced and varied selection of food available, that promotes their well-being. The systems for consultation with the residents in the home are good, with their views both sought and acted upon. The activities provided for residents generally matches their expectations and preferences, thus contributing to their quality of life and independence. EVIDENCE: The routines of the home are flexible, as confirmed by conversations with several of the Sisters. One Sister commented, “Most of us rise quite early in the morning, and can go bed when we like. If we need help, the staff will help us get ready for bed”. Another, commented, “ After tea, I go to my room for a nap. Sometimes I like to sit outside for a while”. A wide range of activities are available for those Sisters who wish to take part, for example, a session of movement to music was taking place and one Sister said, “It was grand, it keeps us moving”. A trip out to Canon Hill Park was planned for a day of fine weather. Carers go with the sisters to assist. A programme of activities included trips to the theatre/ cinema, visiting speakers, a trip to Lourdes and religious retreats. Of significant importance for the Sisters is to be able to participate in the religious services and celebrations of the convent, and staff are always available to facilitate this. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 12 The Infirmary is an integral part of the convent, so the Sisters are able to move freely between the two, thus maintaining their contacts with other Sisters. There is a guest house in the grounds to accommodate visitors. One Sister confirmed that she is visited regularly by her brother and sister. It was evidenced that the Sisters have a range of personal possessions in their rooms which help to create a homely environment. The inspector joined the Sisters for lunch in the spacious first floor dining room. Tables were very attractively laid with a menu on each table. The menus reflect the choices of the Sisters and demonstrate a nutritious and balanced diet is provided. One Sister commented, “The food is always very good with a good choice. It’s food that we like”. Special diets are taken into consideration and Sisters likes and dislikes are confirmed and documented. There were several care staff in attendance during the meal offering assistance where it was required. All sisters where asked their choice of meal, at the table, and also what size portion they would like. There was a choice of boiled gammon with parsley sauce or chicken with gravy, fresh vegetables and potatoes. This was preceded by soup, and a choice of desserts, including rice pudding, apple crumble and custard, prunes, fresh fruit, jelly and cheese and biscuits. A cup of tea or coffee was served after the meal, with most Sisters choosing to take it in the lounge or their room. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 &18 The home has a satisfactory complaints procedure that is accessible to residents and visitors so that they are aware of how to make a complaint ensuring the promotion of protection matters. EVIDENCE: No complaints have been received by the Commission for Social Care Inspection (CSCI) in relation to the home, and there were none recorded in the homes’ log. The complaints policy and procedure includes all the information required to enable a person to make a complaint if they should wish to do so. One Sister said, “I would never feel frightened of making a complaint, but I have nothing to complain about.” The adult protection policy and procedure incorporated the Birmingham Multi Agency Guidelines. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25, & 26 The standard of the environment within St Paul’s Convent Infirmary is very high, providing the sisters with a comfortable, attractive and safe place to live. EVIDENCE: The infirmary is an integral part of the convent buildings which are well maintained and there is a rolling programme of renewal and refurbishment of the Infirmary communal rooms and bedrooms. Records are kept to demonstrate this. The Grounds are accessible, very tidy and attractive. Radiators covers were in place. There are 3 passenger lifts that are regularly maintained, and documentation was seen to support this. Although there are no en suite facilities, all rooms have wash hand basins and there are sufficient communal toilets and assisted bathing facilities to meet the needs of the sisters. There are also showers available for those who prefer a shower to a bath. Individual needs are assessed and catered for by the provision of appropriate aids and adaptations including handrails in corridors and grab rails in toilets. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 15 Passenger lifts give access to all floors of the infirmary. All rooms are fitted with a call bell system, that is regularly maintained. Regular maintenance of the wheelchairs used in the home was evidenced. The bedrooms seen on this occasion appeared comfortable, were suitably decorated to a high standard and personalised to the occupants choosing. Many of the Sisters had furnished their rooms with their own pictures, ornaments and photographs. All bedrooms are provided with a lockable facility and bedroom doors are fitted with privacy locks. The Infirmary demonstrates a thorough approach to meeting health and safety requirements in regards to lighting, heating and water supply and has the appropriate documentation and assessments to support this. All rooms sampled were airy and well ventilated. The areas of the Infirmary seen were very clean and fresh. The standard of housekeeping is commended. There are systems in place for the control of infection and there is a policy and procedure in place. Infected material and clinical waste is handled appropriately, and the home has a current contract with an environmental services company who remove the waste on a regular basis. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 High staffing levels ensure that the needs of the residents are met. The home has a robust recruitment procedure thus ensuring the safety of the residents. Staff have received appropriate training in order to carry out their duties to ensure residents are protected, and cared for appropriately. EVIDENCE: Examination of staffing rotas indicates that the home is always well staffed, with three trained nurses and nine care staff on duty during the day shift, plus the manager and her deputy, which ensures that staff are able to fully met the care needs of the sisters. At night the carers and trained nurse on duty have the support of an on call system in the building if a need arises. The infirmary also employs ancillary staff that includes, dedicated housekeeping staff, cook, kitchen assistants, laundry workers, and a full time maintenance officer. A very high percentage of the care staff, i.e. 90 , are trained to NVQ level 2 which is commended, and far exceeds the expectation of the standard. There is a very robust recruitment procedure operating in the home, and a six week induction programme, to the TOPSS standard, is in place for all new employees. Evidence was seen that this had been implemented. The infirmary maintains records of all training delivered to staff. Evidence was seen that new staff had undergone induction training to the TOPSS guidelines, and all staff had attended updates of mandatory training in fire safety, moving and handling, infection control, health and safety and food hygiene. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 17 Other training provided includes, adult protection, dementia, medication management, Palliative care and Tissue Viability. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 & 38 The home has good systems for consultation with residents where their views are both sought and acted upon. The management style of the home engenders an open and inclusive atmosphere The homes’ high standard of record keeping safeguards the residents’ rights and best interests. The high standard of attention to the health and safety issues for staff and residents help promote and protect their health and welfare. EVIDENCE: The manager of the home is very experienced in running a care home, and is able to demonstrate her competence and dedication in ensuring that the highest levels of care and services are provided to the sisters in the Infirmary. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 19 St Paul’s is a religious institution and therefore has a very clear ethos, however staff come from a wide variety of backgrounds and religions. Staff spoken to stated that they find the management approachable and receptive to views or ideas. Staff and resident meetings take place regularly and a record kept. St. Paul’s has a quality assurance assessment questionnaire that is distributed every six months and the analysis aids in the review of the services offered. Service user meetings take place regularly and are used to provide feedback and air views, and are an integral part of the quality review. All staff have regular formal and documented supervision, and evidence was seen to support this. There are a comprehensive range of policies and procedures in place that where required to do so, follow local guidelines. Maintenance and fire records were all complete and of a high standard, which is commended. All fire drills, alarm tests and fire training were up to date. Passenger lifts and hoists were seen to have been regularly serviced and PAT testing of electrical appliances carried out. Data sheets for the COSHH products used in the home were available. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 4 3 x 3 3 4 4 STAFFING Standard No Score 27 4 28 x 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 4 3 3 x x 3 3 4 St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that when it has been identified that a resident requires the use of a hoist, that the size of the sling to be used is recorded on the assessment sheet. St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 22 Commission for Social Care Inspection Birmingham and Solihull Local Office 1st Floor, Ladywood House 45/46 Stephenson Street Birmingham, B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Pauls Convent 20050823 St Pauls X10015 Stage 4 S24897 V238607 E54.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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